Sean Cahill, Phd and Kali Lindsey, Co-Chairs

Meeting of the

POLICY COMMITTEE

Sean Cahill, PhD and Kali Lindsey, Co-Chairs

March 1, 2011

Federation of Protestant Welfare Agencies

281 Park Avenue South, 2nd Floor Boardroom

3:00 pm – 5:00 pm

Members Present: Gregory Cruz, Yves Gebhardt, Kristin Goodwin, Elaine Greeley, Kali Lindsey, Esther Lok, Lucky Michaels, Jan Carl Park, Andresa Person, Gloria Searson, Dorella Walters

Members Absent: Susan Alston, Sean Cahill, PhD, Kareem Clemons, Christopher Cunningham, Sharon Doctor, Matthew Lesieur, Lorna Littner, Paul Meissner, Kimberly Sanders, Susan Wayne

NYC DOHMH Staff Present: JoAnn Hilger, Nina Rothschild, DrPH

Material Distributed:

Agenda
Minutes from the February 1, 2011 Meeting of the Policy Committee
List of Open and Closed Items
Planning Council Testimony Submitted to NYS Medicaid Redesign Team
Letter of Invitation to NYS Health Commissioner Nirav Shah, MD, MPH
Letter to Members of NYS Assembly Ways and Means Committee re 30 Percent of Income Toward Rent
Letter to Members of NYS Senate Finance Committee re 30% of Income Toward Rent
Letter of Invitation to Monica Sweeney, MD, MPH (Follow-Up to Presentation to PC)
Letter to Members of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health
Letter to Commissioner of Social Security re Revising the Disability Listings

Proposals Approved by the NYS Medicaid Redesign Team on February 24, 2011
Planning Council March 2011 – Month at a Glance
Planning Council Calendar for March 2011
Information from HRSA on Funding Restrictions onLobbying

Welcome/Introductions/Moment of Silence/Review of the Meeting Packet: Committee Co-Chair Kali Lindsey welcomed meeting participants. Members observed a moment of silence. Meeting participants introduced themselves and discussed their specific interests in HIV policy and the resources they bring to the table. Nina Rothschild reviewed the contents of the meeting packet.

Petition Against NYC DOHMH Public Service Announcement “It’s Never Just HIV”: Kristin Goodwin introduced the petition calling on NYC DOHMH to withdraw the public service announcement “It’s Never Just HIV.”

HRSA Site Visit: Governmental Co-Chair Jan Carl Park discussed the upcoming HRSA site visit regarding the role of the Planning Council and the grantee. HRSA will explain the proper functioning of and boundaries between Planning Council and grantee and how other jurisdictions address these issues.

Lobbying, Advocacy, and Education: Jan Carl Park noted that the issue of lobbying emerged during a conversation with our HRSA project officer, Kerry Hill. We learned that most of the letters drafted by the Policy Committee constitute lobbying and are not permissible under HRSA rules: all of our activities are paid for with federal dollars, and we cannot use federal dollars to lobby for more dollars. Mr. Park also noted that HRSA asked why the NY EMA is paying for two consumer committees, when most jurisdictions have only one.

JoAnn Hilger, Ryan White Grant Administrator, reviewed the HRSA guidelines on lobbying. Committee member Esther Lok provided the City and State definition of lobbying, noting that if you have an “ask” – e.g., you are asking the State to restore funding – the drafting of the letter and the meeting to discuss the plan are considered grassroots community organizing, not lobbying. Submitting a letter or testimony during a public comment period, moreover, does not constitute lobbying, nor does asking for restorations or more funding for a general pool (as opposed to a specific agency). Ms. Lok stated that providing education about the implications of a policy decision does not constitute lobbying.

Ms. Hilger stated that HRSA will discuss our roles and responsibilities and that we have to do exactly what they say. Co-Chair Kali Lindsey suggested that the Committee formulate several specific questions for HRSA:

What is the line in the sand between community organizing, lobbying, and advocacy?
What is lobbying?
Ask Jan – something about forums?
What are lobbying expenses?

Committee members reviewed all of the letters sent during the past several months to determine which constitute lobbying and which constitute advocacy. The following letters constitute lobbying and are not acceptable going forward:

Letters to NYS Assembly Ways and Means Committee and NYS Finance Committee re 30% of income toward rent
Letter to Guillermo Chacon of LCOA asking re the Governor’s strategy for increasing access to care for PLWHAs and his position on 30% of income toward rent
Letters re appropriations
Letter to HRSA Administrator re broad local discretion regarding length of stay in RW-funded housing
Letter to FDA Commissioner re overturning the ban on blood donations by MSM
Letter to House Leadership supporting the Affordable Care Act and emphasizing its benefits for PLWHAs

The following letters constitute advocacy and are acceptable:

Letter to President Obama’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health
Letter to Social Security Administration Commissioner Astrue about Social Security and Disability
Letter inviting Dr. Nirav Shah, Governor Cuomo’s Health Commissioner, to address the PC
Letters to Mayor Bloomberg and Dr. Monica Sweeney re Public Service Announcement “It’s Never Just HIV”

Activities for the Policy Committee that would be acceptable include inviting a representative of the Prevention wing of the Bureau of HIV/AIDS Prevention and Control to make a presentation on prevention work with SEPs.

Committee members asked whether there is a difference between writing in order to influence versus to interpret and understand. Dorella Walters asked whether the PC can sign on to letters generated by other organizations. The answer is no. Kali Lindsey noted, however, that we can educate fellow members of the Planning Council. If Dr. Sweeney answers the questions we sent her in a letter following up on her talk to the Planning Council about the PSA, we can provide her answers to others, and they can take action on their own. Members agreed on the need for a robust discussion of allowable activities and for a clarification of our role within the structure of the Planning Council. We should discuss a way to deal with these issues moving forward.

Esther Lok asked whether other jurisdictions have Policy Committees. Jan Park noted that they may take opinions on policy issues – but as far as we know, most EMAs do not have Policy Committees.

Members noted that City and State funds for syringe exchange programs are being cut and asked whether we want to advocate for PSRA to allocate additional funds to needle exchange.

Committee members agreed on the need to watch Medicaid reform carefully on the State level. If, for example, the State disallows payment for home aides, then we might want to consider funding home health at a higher level than we do at present.

Medicaid Redesign Team: The Medicaid Redesign Team reviewed many proposals for cutting $2.85 billion from the Medicaid budget. The Team operated through a series of town hall meetings. Proposals were considered and compiled, and some were approved and sent on to the Legislature. Committee members discussed several of the proposals:

#6 calls for cutting Medicaid spending (payments to providers) by 2%
#26 concerns service caps and rate reductions and affects OASAS and mental health services more than COBRA. After 30 visits, additional visits must be reauthorized.
#93 concerns managed care for behavioral health
#196 – a measure to reduce Medicaid expenditures through supportive housing. Not clear is whether this proposal is intended for PLWHA. We know that housing issues have a dramatic impact on quality of life in the EMA.
#4651 concerns a cap on spending: no more than 4% annual growth

Dorella Walters asked how all these changes related to managed care affect the SNPs for PLWHAs. Policy Committee members discussed these Medicaid proposals which will be included by Governor Cuomo in his proposed budget.

Adjournment: The meeting was adjourned.